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HIM Medical Coding Specialist

Scope/Impact

The Medical Coding Specialist is a certified/credentialed medical coding professional with a minimum three years’ experience coding medical Inpatient, Outpatient Facility or Pro Fee services. The medical coding department operates in a high quality/low production coding environment. Comanche County Medical Center is a Critical Access Hospital with a maximum capacity of 25 beds, allowing concentrated time for exceptional coding skill developments. The coding/EMR system includes 3M and Encoder Pro for effective, efficient and accurate coding for coders familiar with the CPT/ ICD CM/PCS coding guidelines.  The Professional Medical Coder will work independently under the direction of coding manager. Work production is maintained through system measures including quality performance measure, audits and productivity accountability. This position requires consistent and effective communication with providers and medical records specialist, demanding a professional demeanor.  The certified/credential medical coder identifies and forwards charting deficiencies to the appropriate department for resolution, querying provider for additional information and code completed charts for billing. The certified/credential medical coder serves as a liaison for the HIM-Coding department and Revenue Cycle Management team, resolving coding errors and claim denials. As a certified /credential medical coder all credential/certifications must remain active. The successful medical coder must be committed to accurate medical professional coding for inpatient and outpatient services, diagnostic tests and Pro Fee medical services rendered to each patient.

 

Job Functions

  • Will assign all CPT ICD CM, ICD 10 PCS, and CPT codes.
  • Medical Coding Specialist will follow all coding guidelines identified within the ICD CM, ICD PCS and CPT coding Guidelines
  • Is expected to adhered to CMS, OIG, Insurance carriers and other governing body’s policies and guidelines to assure the most appropriate ICD 10, ICD 10 PCS and CPT codes are assigned.
  • Ensures code assignments are based on the current and active data sources
  • Is expected to meet coding production.
  • Completes assigned reports to address claim denials and coding errors.
  • Communicates through queries, with physicians and other health care professionals, in the absence of complete medical records
  • Review patient charts and documents for accuracy and completeness
  • Reports missing or incomplete documentation
  • Work with the Revenue Cycle Management team to address coding issues and claim denials
  • Actively participate in the Edit and Denial resolution process
  • Must remain flexible and able to work on-site or off-site
  • Must perform additional duties as assigned

Credential(s)

Required:

One or more of the following:

  • AHIMA- Certified Coding Specialist (CCS) or Certified Coding Specialist – Professional (CCS-P) ; or
  • AAPC-Certified Professional Coder (CPC) or Certified Outpatient Coder (COC)

 

Education Required

Required:

High school diploma or equivalent

Understanding of medical terminology, anatomy & physiology and pharmacology

Preferred:

Completion of some college level HIM/Coding courses

Medical Coding Certification

 

Amount and Type of Experience

Required:

Advanced knowledge of personal computers, Advanced knowledge of Microsoft office Suites, including Excel, Power Point, Word.   Advanced knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS codes –Ability to work with EMR/Encoders

 

SKILLS

  • Medical Inpatient/Outpatient or Pro Fee Coding Guidelines
  • Ability to Think analytically/critically
  • Effective Oral/Written communications
  • Maintain coding credential(s) and attends in-service training as required
  • Ability to work independently or as an active member of a team
  • Strong computer skills in data entry, coding, and knowledge of 3M Encoder software
  • Accurate and precise attention to detail
  • Ability to multitask, prioritize, and manage time efficiently
  • Problem Solver

 

ORGANIZATIONAL UNIVERSAL COMPETENCY REQUIREMENTS:

Models CCMC values:

  • Demonstrates high ethical and legal standards.
  • Follows regulatory and compliance standards.

 

ORGANIZATIONAL CORE COMPETENCY REQUIREMENTS:

  • Communicates openly and timely to address, prevent or curcumvent potient departmetnal problems/issues or breaches/litigations
  • Shares information appropriately.  Encourages and receives differential
  • Responds promptly to messages/requests.

Position Type

Job Location

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